Monitoring plasma concentrations of anti–tumor necrosis factor agents could optimize treatment of patients with Crohn's disease.
In a post hoc analysis of data from a clinical trial, Dr Jean–Frédéric Colombel and colleagues compared the relationship between plasma concentrations of certolizumab pegol and endoscopic and clinical responses and remission with certolizumab pegol therapy in patients with moderate to severe ileocolonic Crohn's disease.
The research team analyzed data from the Endoscopic Mucosal Improvement in Patients with Active Crohn's Disease Treated with certolizumab pegol trial, from 89 adult patients with active endoscopic Crohn's disease.
Patients received subcutaneous certolizumab pegol (400 mg) at weeks 0, 2, and 4 and then every 4 weeks until week 52.
|Higher concentrations of certolizumab pegol at week 8 were associated with endoscopic response|
|Clinical Gastroenterology & Hepatology|
Endoscopic evaluations were performed at weeks 0, 10, and 54.
The research team found that blood samples were collected to measure certolizumab pegol plasma concentrations at weeks 8 and 54.
Certolizumab pegol quartiles at weeks 8 and 54 were correlated with endoscopic response and remission at weeks 10 and 54, respectively.
The team noted that higher concentrations of certolizumab pegol at week 8 were associated with endoscopic response, and remission at week 10.
At week 54, the research team found that rates of endoscopic remission correlated with plasma concentrations of certolizumab pegol.
There was a significant inverse relationship between plasma concentrations of certolizumab pegol, and baseline levels of C-reactive protein and body weight.
Dr Colombel's team concludes, "Endoscopic response and remission are associated with higher plasma concentrations of certolizumab pegol in patients with moderate to severe ileocolonic Crohn's disease."
"These results support the need to consider the pharmacokinetics of anti–tumor necrosis factor agents and therapeutic drug monitoring to optimize treatment."